Oral Health Disparities in Publicly Insured Children

描述(由申请者提供)：此申请是通过NIDCR学者发展和教师过渡奖的教师过渡阶段获得的NIH职业奖。这项申请提出了一个全面的跨学科的必要的培训和指导计划，以发展成为一名独立的调查人员。申请人有承诺和对研究和学术牙科感兴趣的既定记录。问题：这个国家在获得牙科保健方面存在很大差距，特别是低收入儿童和有特殊卫生保健需要的儿童。目的：该项目调查北卡罗来纳州和弗吉尼亚州现有公共保险计划中为儿童(1-18岁)提供的口腔保健在获得牙科保健和儿科表现方面的差异。方法：北卡罗来纳州(北卡罗来纳州)的公共保险牙科计划(Medicaid/SCIP)作为收费计划进行管理，而弗吉尼亚州(弗吉尼亚州)的公共保险儿童同时参加管理性护理组织和收费牙科计划。该项目将研究卫生保健组织因素的影响，如管理性保健与收费服务计划，以及计划绩效衡量标准对儿童口腔健康结果的差异。目的：第一项研究将描述两个州公共保险儿童在三年期间(2001-2003)的登记动态和获得牙科服务的情况。第二项研究将审查这三年期间儿童牙科计划的绩效(利用率、预防效果和质量)。第三项研究将检查1-5岁注册儿童使用医院和传统牙科环境的可能性。第四项研究是一项可行性研究，旨在探讨口腔健康个案管理在医疗领域的临床意义。好处：这种定量技术和临床研究的组合将被用来解决NIDCR消除口腔健康差异的优先研究领域。

DESCRIPTION (provided by applicant): This application is for a NIH Career Award through the Faculty Transition Phase of the NIDCR Scholar Development and Faculty Transition Award. This application proposes a comprehensive interdisciplinary program of necessary training and mentorship to develop into an independent investigator. The applicant has an established record of commitment and interest in research and academic dentistry. Problem: There are significant disparities in access to dental care in this country, particularly for low-income children and those with special health care needs. Purpose: This project investigates disparities in access to dental care and pediatric performance measures of oral health care provided to children (1-18 years) enrolled in public insurance programs that currently exist in North Carolina and Virginia. Methods: North Carolina's (NC) public insurance dental plans (Medicaid/SCHIP) are administered as fee-for-service programs, while Virginia's (VA) publicly insured children are enrolled in both managed care organizations and fee-for-service dental programs. This project will examine the impact of health care organizational factors such as managed care versus fee-for-service programs and the difference in plan performance measures on pediatric oral health outcomes. Aims: The first study will describe the dynamics of enrollment and the access to dental services over a three-year period (2001-2003) of publicly insured children in both states. The second study will examine the performance of dental plans (utilization, effectiveness of prevention and quality) for children over this three-year period. The third study will examine the likelihood of hospital use versus the conventional dental setting for enrolled children 1-5 years of age. The fourth study is a feasibility project aimed at exploring the clinical implications of oral health case management in the medical arena. Benefit: This mix of quantitative techniques and a clinical study will be utilized to address the NIDCR Priority Research Area of eliminating oral health disparities.